The introduction of the iPhone delivered into people’s hands a technology that continued the dissemination of knowledge started by the internet. Not since the invention of the printing press has any technology had such a profound effect on society.
The transmission of knowledge to the people carries with it a massive shift in the locus of power within society; the healthcare system is merely one area that will be transformed.
Whilst contemplating how best to respond, the changes will occur around them. As such, the emergence of the new is most likely to come from outside existing health systems and will be funded by venture capital.
The most noticeable manifestation of these changes in the UK has been the rapid emergence of online digital health apps such as Babylon as a virtual platform for delivering general practice services. NHS Hammersmith and Fulham CCG are supporting a pilot of Babylon’s technology – implemented as GP-at-Hand – which gives people the choice to access their general practice services using their smartphones.
In the end consumer choice will be the driving force behind changes to the health system
An assessment of the model has been commissioned and will run until April 2019. But we already know that in the initial months, over 30,000 have registered with this new service. Its appeal is mainly to the low-use, low-need segment of the population where speed of access and convenience is their critical issue.
The response to this phenomenon is, understandably, mixed.
NHS Birmingham CCG is continuing to block a proposal to introduce the Babylon system on the grounds of ‘patient safety’.
At the same time, a federation of 56 GPs practices in Birmingham, covering a population of 300,000, has introduced its own virtual service for patients that has been rated ‘outstanding’ by the CQC.
In the London pilot, Babylon is currently using four NHS practices to provide limited physical follow-up for any patients that need to be seen, although it is reportedly in consultation with architects to design a physical structure for their system.
Will NHS executives manage to develop a business model that supports NHS general practices as a whole, or will Babylon and its ilk continue to develop its services and artificial intelligence as an alternative to NHS general practice?
In the end consumer choice will be the driving force behind the changes to the health system. Only time will tell whether the NHS has what it takes to respond.
Dr Jonathan Simon is a retired GP in west Sussex and former honorary secretary of the Royal New Zealand College of GPs
